| NPI | 1518578442 |
|---|---|
| Former Name | KIERSTYN PAIGE LATCHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AK 181591) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AR 4570) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2021-10-12 |